Error code
SA — Surgical procedure allowed at consultation fee
Paid at consultation fee
The surgical procedure was paid at the consultation fee because, for this referred case, the surgical fee was lower.
What to do: Nothing to fix; don't bill a separate consultation or post-operative visits for the same case.
- Code
- SA
- Description
- Surgical procedure allowed at consultation fee
Explanation
Updated October 26, 2026
SA means the surgical procedure was paid at the consultation fee, as the Surgical Preamble allows when the surgical fee is lower.
What it means
Code SA means OHIP paid this surgical procedure at the value of the surgical consultation fee.
The Surgical Preamble allows this for a referred case when the surgical fee (non-IOP, Complete Care, Fracture or Dislocation) is less than the surgical consultation fee. The consultation is claimed under the procedure code so that it doesn't count toward consultation limits, and nothing more should be claimed because it replaces the pre-, post-operative and surgical care (SP4, paragraph 11).
Common causes
- A low-fee procedure on a referred patient (expected)
How to fix it
- No correction is needed if the patient was referred and the consultation value is higher than the listed surgical fee.
- Don't bill a separate consultation or post-operative visits for the same case.
- If you think the amount is wrong, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date.
Don't resubmit if
- You want to add a separate consultation for the same case. The consultation value is already paid.
- The claim is already on your Remittance Advice. Use an RAI, not a new claim.
How APEX handles it
APEX reads your error reports and remittance advice from MCEDT and lists claims rejected with this code in its Correction Centre for you to correct and resubmit. See how APEX works · Pricing